Heights University Hospital

All Charges

Charge

Type

Setting

Price

STE LIB MONO 3.0x32m 389343230

Facility

$4,375.00

Hospital Charge Code	270639378
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STE LIB MONO 3.0x32m 389343230

Facility

$4,375.00

Hospital Charge Code	270639378
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,312.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STEM 10MM STD COMP PRIM

Facility

$20,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270699795
Hospital Revenue Code	278
Min. Negotiated Rate	$3,018.75
Max. Negotiated Rate	$10,062.50
Rate for Payer: Aetna Commercial	$6,037.50
Rate for Payer: Aetna Medicare Advantage	$6,037.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,131.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,131.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,131.88
Rate for Payer: Cigna Commercial	$10,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,870.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,018.75

STEM 10MM STD COMP PRIM

Facility

$20,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270699795
Hospital Revenue Code	278
Min. Negotiated Rate	$3,018.75
Max. Negotiated Rate	$4,870.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,870.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,018.75

STEM 10 MM X 0 MM

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270685943
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$3,450.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

STEM 10 MM X 0 MM

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270685943
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

STEM 10mmX6.MM

Facility

$10,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270682765
Hospital Revenue Code	278
Min. Negotiated Rate	$1,623.75
Max. Negotiated Rate	$2,619.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,619.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,623.75

STEM 10mmX6.MM

Facility

$10,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270682765
Hospital Revenue Code	278
Min. Negotiated Rate	$1,623.75
Max. Negotiated Rate	$5,412.50
Rate for Payer: Aetna Commercial	$3,247.50
Rate for Payer: Aetna Medicare Advantage	$3,247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,760.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,760.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,760.38
Rate for Payer: Cigna Commercial	$5,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,619.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,623.75

STEM 11 130 DEG TI CANN 380mm

Facility

$9,942.75

Service Code	HCPCS C1776
Hospital Charge Code	270678866
Hospital Revenue Code	278
Min. Negotiated Rate	$1,491.41
Max. Negotiated Rate	$2,406.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,988.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.41

STEM 11 130 DEG TI CANN 380mm

Facility

$9,942.75

Service Code	HCPCS C1776
Hospital Charge Code	270678866
Hospital Revenue Code	278
Min. Negotiated Rate	$1,491.41
Max. Negotiated Rate	$4,971.38
Rate for Payer: Aetna Commercial	$2,982.82
Rate for Payer: Aetna Medicare Advantage	$2,982.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,535.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,535.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,988.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,535.40
Rate for Payer: Cigna Commercial	$4,971.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.41

STEM 12mmX 250mm

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677750
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

STEM 12mmX 250mm

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677750
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

STEM 12MMX50MM TRIATHLON

Facility

$11,965.00

Service Code	HCPCS C1776
Hospital Charge Code	270691990
Hospital Revenue Code	278
Min. Negotiated Rate	$1,794.75
Max. Negotiated Rate	$2,895.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,393.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,895.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,794.75

STEM 12MMX50MM TRIATHLON

Facility

$11,965.00

Service Code	HCPCS C1776
Hospital Charge Code	270691990
Hospital Revenue Code	278
Min. Negotiated Rate	$1,794.75
Max. Negotiated Rate	$5,982.50
Rate for Payer: Aetna Commercial	$3,589.50
Rate for Payer: Aetna Medicare Advantage	$3,589.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.07
Rate for Payer: Cigna Commercial	$5,982.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,895.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,794.75

STEM 3M FEMUR SZ 11 LEFT

Facility

$18,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270692715
Hospital Revenue Code	278
Min. Negotiated Rate	$2,835.00
Max. Negotiated Rate	$9,450.00
Rate for Payer: Aetna Commercial	$5,670.00
Rate for Payer: Aetna Medicare Advantage	$5,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,819.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,819.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,819.50
Rate for Payer: Cigna Commercial	$9,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,573.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,835.00

STEM 3M FEMUR SZ 11 LEFT

Facility

$18,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270692715
Hospital Revenue Code	278
Min. Negotiated Rate	$2,835.00
Max. Negotiated Rate	$4,573.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,573.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,835.00

STEM 5 DEG PSN TIB SZ C L

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689591
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM 5 DEG PSN TIB SZ C L

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689591
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM 5 DEG SZ F RIGHT

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690962
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM 5 DEG SZ F RIGHT

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690962
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM 6.5MM 496-S065

Facility

$5,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270628373
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$1,445.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

STEM 6.5MM 496-S065

Facility

$5,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270628373
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$1,792.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

STEM 7853-013-21

Facility

$10,546.45

Hospital Charge Code	270629986
Hospital Revenue Code	278
Min. Negotiated Rate	$1,581.97
Max. Negotiated Rate	$5,273.23
Rate for Payer: Aetna Commercial	$3,163.93
Rate for Payer: Aetna Medicare Advantage	$3,163.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,689.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,689.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,109.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,689.34
Rate for Payer: Cigna Commercial	$5,273.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,552.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,581.97

STEM 7853-013-21

Facility

$10,546.45

Hospital Charge Code	270629986
Hospital Revenue Code	278
Min. Negotiated Rate	$1,581.97
Max. Negotiated Rate	$2,552.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,109.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,552.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,581.97

STEM 7MM DIA X 2MM TR

Facility

$9,820.00

Hospital Charge Code	270666832
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.00
Max. Negotiated Rate	$4,910.00
Rate for Payer: Aetna Commercial	$2,946.00
Rate for Payer: Aetna Medicare Advantage	$2,946.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,504.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,504.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,964.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,504.10
Rate for Payer: Cigna Commercial	$4,910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,376.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.00

Know your out-of-pocket cost for care.

All Charges